缩短禁欲时间对重度精子DNA损伤患者体外授精结局的改善作用

The effect of shortening abstinence time on in vitro fertilization outcome in patients with severe sperm DNA damage

目的探讨缩短禁欲时间对重度精子DNA碎片指数(DFI)患者体外授精(IVF)结局的改善作用。方法选取2018年11月至2020年6月行IVF治疗的DFIM20%的不孕不育夫妇200对,随机分为两如(毎组100对),设定WF治疗时禁欲时间1〜5 h为观察组,2~7 d为对照组。分别比较两组IVF治疗前和IVF治疗时的精液常规质量指标与DFI,并比较两组IVF临床结局。结果调整前,两组精液常规质量指标和DFI均无差异无统计学意义(均P>0.05)o调整后,-观察组精液体积、精子浓度和DFI均极低于对照组(均P<0.01),前向运动率高于对照组(P<0.01)。IVF结局,观察组优质胚胎率达39.09%,高于对照组31.18%(P<0.01)o胚胎移植后,观察组种植率、临床妊甥率和早期流产率分别为33.54%、55.95%和14.89%,优于对照组21.93%、37.10%和39.13%,差异有统计学意义(均P<0.05)o结论缩短禁欲时间可以降低重度DFI患者的精子DNA损伤程度,并可改善重度DFI患者IVF结局中的优质胚胎率、种植率、临床妊娠率和早期流产率。

Objective To investigate the role of abstinence time in the reproductive outcomes of patients with severe sperm DNA fragmentation index(DFI)with invitro fertilization(IVF).Methods 200 couples with DFIM20%who have accepted IVF in reproductive medicine center of our hospital from November 2018 to June 2020,were selected and randomly divided into two groups(100 couples in each group).The abstinence time was reduced to 1~5 hours for the experimental group during IVF treatment,while the control group remains the same as before(2~7 days).The semen routine quality indexes,DFI and reproductive outcomes of the two groups were compared.Results There were no significant difierences in semen routine quality index and DFI for the two groups before adjustment(all P>0.05).After adjustment,the semen volume,sperm concentration and DFI in the experimental group were significantly lower than those of the control group(all P<0.01).The forward moving motility&om the experimental group was significantly higher than that of the control group(P<0.01).The good-quality embryo rate of the experimental group was increased to 39.09%after adjustment,which was significandy higher than that of the control group(31.18%)(P<0.01).After embryo transfer,the experimental group had much better performance than the control one regarding the rates of implantation,clinical pregnancy and early miscarriage(experimental group,33.54%,55.95%and 14.89%;control group,21.93%,37.10%and 39.13%).Conclusion Reducing male abstinence time to less than one day can prevent the sperm DNA damage in patients bearing with severe DFI,and can significantly improve the good-quality embryo rate,implantation rate,clinical pregnancy rate and early miscarriage rate in patients receiving IVF.